Larger Ascending Aorta in Primary Aldosteronism: A 3-year Prospective Evaluation of Adrenalectomy vs Medical Treatment


Primary aldosteronism is associated with higher cardiovascular morbidity as compared with essential hypertension. Vascular complications encompass myocardial infarction and cerebrovascular events. Aortic damage in primary aldosteronism has never been explored, although a few cases of ascending aorta aneurysms have been reported. We consecutively enrolled patients affected by primary aldosteronism (n = 45) and compared them with patients affected by essential hypertension (n = 47), on an outpatient setting. Echocardiographic data of patients with primary aldosteronism were collected during a mean follow-up of 3 years, in subjects who underwent adrenal surgery (n = 12) and those on mineralocorticoid receptor antagonists (n = 33). We found that patients with primary aldosteronism had larger ascending aorta diameters than those with essential hypertension before starting any specific treatment. Patients with primary aldosteronism did not show significant changes in the size of ascending aorta during a mean of 3 years of follow-up, irrespective of the type of treatment (medical vs. surgical treatment). A longer follow-up will better clarify if worsening of the aortic damage may be better prevented by surgery rather than by mineralocorticoid receptor antagonists.

Authors: Guido Zavatta, Guido Di Dalmazi, Carmine Pizzi, Giovanni Bracchetti, Cristina Mosconi, Caterina Balacchi, Uberto Pagotto & Valentina Vicennati
Keywords: adrenal cortex, aldosterone, aortic aneurysm, aortic root, ascending aorta, primary aldosteronism
DOI Number: 10.1007/s12020-018-1801-3      Publication Year: 2019

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